Recommendations for skin cancer monitoring for patients with chronic lymphocytic leukemia

Mulcahy, Anthea; Mulligan, Stephen P.; Shumack, Stephen

doi:10.1080/10428194.2017.1349903

Cited by 13 publications

(10 citation statements)

References 26 publications

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“…The authors emphasize once again on the importance of a dermatological evaluation at least annually by a doctor who has expertise in skin-cancer diagnosis. 62 …”

Section: Discussionmentioning

confidence: 99%

“…The authors emphasize once again on the importance of a dermatological evaluation at least annually by a doctor who has expertise in skin-cancer diagnosis. 62 Nonetheless, in patients with CLL and melanoma there are several pitfalls for the clinician that should be pointed out. As already mentioned, in the rare cases of collision of tumors in lymph nodes biopsied to stage a melanoma, detection of BRAF mutations should be performed on skin and bone-marrow samples to avoid the possibility of a BRAF wild-type melanoma being misdiagnosed as a BRAF-mutated melanoma in cases of BRAF-mutated CLL.…”

Section: Proposed Guidelines For Patients With Cll With and Without Melanomamentioning

confidence: 99%

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Clinical considerations about the coexistence of melanoma and chronic lymphocytic leukemia in the era of targeted therapies, triggered by rare clinical scenarios. A case series and review of the literature

et al. 2020

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The epidemiologic correlation of melanoma and chronic lymphocytic leukemia (CLL) has been the subject of several population studies. In the present article, through the presentation of five illustrative cases of patients with melanoma and CLL, several aspects of this complex relationship are highlighted, with a focus on the increased incidence of melanoma in patients with CLL, its speculated etiology, and the impact of CLL stage and disease duration on the incidence and prognosis of melanoma. Furthermore, the rare entity of the synchronous diagnosis of melanoma and CLL in biopsied lymph nodes is discussed, along with its implications on the diagnostic and therapeutic procedures. In addition, the available data on the treatment choices in patients with melanoma and CLL are presented and the efficacy and safety of fludarabine, anti-CD20 monoclonal antibodies, new targeted therapies for CLL, and checkpoint inhibitors are further discussed. Finally, since no formal guidelines are available for the management of this group of patients, guidelines are proposed for skin-cancer screening in patients with CLL, for the correct interpretation of BRAF mutation analysis in lymph-node specimens with ‘collision of tumors,’ and for the optimal use of imaging studies in the diagnosis of metastatic disease in patients with CLL and melanoma, while a treatment approach for such patients is also suggested. The information and proposed guidelines provided in the present article comprise a useful guide for physicians managing such patients, focusing on diagnostic challenges and therapeutic dilemmas posed by the coexistence of the two disease entities.

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“…The authors emphasize once again on the importance of a dermatological evaluation at least annually by a doctor who has expertise in skin-cancer diagnosis. 62 …”

Section: Discussionmentioning

confidence: 99%

Section: Proposed Guidelines For Patients With Cll With and Without Melanomamentioning

confidence: 99%

Clinical considerations about the coexistence of melanoma and chronic lymphocytic leukemia in the era of targeted therapies, triggered by rare clinical scenarios. A case series and review of the literature

et al. 2020

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“…Although an association between leukemia and AK has not been reported yet, increased skin cancer risk in chronic lymphocytic leukemia was reported, with rates approximately double those in the general population 36 . Therefore, Mulcahy et al recommended skin cancer monitoring for patients with chronic lymphocytic leukemia 37 . The increased risk of skin cancer in leukemia patients was explained by their immunocompromised state 38 , but we found in this study an increased risk of leukemia in patients with AK compared with controls vice versa.…”

Section: Discussionmentioning

confidence: 99%

Positive association between actinic keratosis and internal malignancies: a nationwide population-based cohort study

Lee

Kim

et al. 2021

Sci Rep

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Little is known about the comorbidities in actinic keratosis patients. To evaluate the association of actinic keratosis with certain malignancies. All patients with actinic keratosis (n = 61,438) and age- and sex-matched control subjects (n = 307,190) at a 5:1 ratio were enrolled using data from the Korean National Health Insurance Service between the years 2007 and 2014. In subjects with actinic keratosis, overall cancer incidence was higher than that for controls after income level, habitat, diabetes, hypertension, and dyslipidemia were adjusted (Hazard Ratio [HR] = 1.43 [95% confidence interval 1.38–1.47]). The positive association of specific cancers were observed in the following order: skin cancer (HR = 3.43 [2.47–4.75]), oral cavity and pharyngeal cancer (HR = 1.99 [1.57–2.52]), lymphoma (HR = 1.59 [1.28–1.96]), leukemia (HR = 1.35 [1.03–1.77]), prostate cancer (HR = 1.35 [1.21–1.51]), renal cancer (HR = 1.29 [1.02–1.63]), liver cancer (HR = 1.21 [1.09–1.35]), thyroid cancer (HR = 1.20 [1.05–1.38]), and gastric cancer (HR = 1.13 [1.03–1.23]). Although further research on pathologic mechanism is needed, the implications of a positive correlation between actinic keratosis and internal organ malignancies has great significance.

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“…Dabei kann die Diagnosestellung anderer kutaner Neoplasien durch die CLL‐Infiltrate sowohl klinisch als auch histologisch erheblich erschwert werden. Da für Patienten mit CLL zusätzlich ein bis zu 8‐fach erhöhtes Risiko für kutane Neoplasien beschrieben wird, ist unbedingt auf eine engmaschige dermatologische Vorsorge in diesem Patientengut zu achten .…”

Section: Kommentarunclassified

Hautinfiltrate einer chronisch lymphatischen Leukämie getriggert durch topische Imiquimodtherapie

Hartmann

Enk

Toberer

2019

J Deutsche Derma Gesell

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Ein 78-jähriger Patient stellte sich mit seit etwa 4 Wochen bestehenden Hautveränderungen am Capillitium vor. Es lag ein guter Allgemeinzustand vor, weitere Symptome wie Juckreiz oder Schmerz wurden verneint. Bei seit mehreren Jahren bekannten aktinischen Keratosen am Capillitium war eine Lokaltherapie mit Imiquimodcreme 3,75% über 2x zwei Wochen durchgeführt worden, diese wurde etwa 4 Wochen vor dem Auftreten der aktuellen Hauterscheinungen beendet. Zudem litt der Patient an einem Adenokarzinom der Prostata sowie eine chronisch lymphatische Leukämie (CLL). Bezüglich der CLL erfolgte aktuell eine Therapie mit Prednisolon 25mg/d.

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Recommendations for skin cancer monitoring for patients with chronic lymphocytic leukemia

Cited by 13 publications

References 26 publications

Clinical considerations about the coexistence of melanoma and chronic lymphocytic leukemia in the era of targeted therapies, triggered by rare clinical scenarios. A case series and review of the literature

Clinical considerations about the coexistence of melanoma and chronic lymphocytic leukemia in the era of targeted therapies, triggered by rare clinical scenarios. A case series and review of the literature

Positive association between actinic keratosis and internal malignancies: a nationwide population-based cohort study

Hautinfiltrate einer chronisch lymphatischen Leukämie getriggert durch topische Imiquimodtherapie

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